Cardiac arrest casualties form a valuable source of donor kidneys

Dr Marie-Reine Losser, from the Paris Diderot University (Paris-7), worked with a team of French researchers to trial the retrieval protocol in the Hôpital Saint-Louis (Assistance Publique-Hôpitaux de Paris). She said, "Patients dying from sudden out of hospital refractory cardiac arrests may be eligible kidney donors. In the system we describe, the emergency services referred such patients to our institution under continuous ventilation and CPR. After death was certified, the kidneys were preserved while approval for donation was sought from the patient's next of kin".

Between February 1st 2007 and June 30th 2008, 122 patients were referred to the hospital in this way, and 49 were found to be eligible for organ retrieval. The families of 15 of these patients refused consent for organ donation, in 12 cases in the absence of or contrary to the donor's previously expressed wishes. From the remaining patients, 31 kidneys were transplanted and at least 27 of these transplants were ultimately successful.

According to Losser, the procedure raised ethical controversies in France, "The question emerged about a conflict of interest between patient care and potential organ procurement. In fact, in this cohort, resuscitation duration was always longer than recommended. There is, however, a clear need for better acceptance of organ donation within the population, something that could be achieved by sustained nationwide information campaigns".

More information: Kidney retrieval after sudden out of hospital refractory cardiac arrest: a cohort of uncontrolled non heart beating donors; Fabienne Fieux, Marie-Reine Losser, Eric Bourgeois, Francine Bonnet, Olivier Marie, Francois Gaudez, Imad Abboud, Jean-Luc Donay, France Roussin, Francois Mourey, Frederic Adnet and Laurent Jacob; Critical Care (in press); http://ccforum.com/

Source: BioMed Central (news : web)